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tv   Politics and Public Policy Today  CSPAN  June 1, 2016 11:25am-1:26pm EDT

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point to really drive home is that while people like to think of large events like hurricanes as social equalizers, they don't discriminate, the truth is is that they exacerbate the underlying socioeconomic problems we face year round. in order for us to truly care about the impacts of climate change we have to think about housing and the fact that there's a shortage of about 5 million homes for low income people in this country. that means that local income people and people of color are living in areas that are most vulnerable to climate change because they're the most affordable. we have to think about displacement and how after an event such as hurricane katrina communities are completely disconnected from the resources that they once held true to their every day lives. so we've talked a lot about new orleans. only a fraction of the families that lived in the lower ninth
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ward have returned. largely because of the fact that the cost of your -- the value of your property rather was taken into account of how much recovery money you got. so you saw people who had similar damage to more affluent house holds but were short changed $75,000 because their properties were not worth the same. we have to care about the fact that -- we talk a lot about fossil fuels. but we don't talk as much about the fact that people of color and low income people disproportionately live near these polluting plants. you know, the super dome is a symbol in any ways for what happened after katrina. and i have to take that symbol into this discussion further in that the baton rouge exxon mobil refinery is 250 times the size of the superdome and 75% of the people that live around it are
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people of color. throughout cancer alley you have the facilities that have remains of slave burial grounds. throughout the history of our country, the black lives have been intertwined and in the pathway of destruction for environmental hazards. if you care about climate change, you have to really dig deep into these issues. i think that we're at an unprecedented time because of the attention that's paid on flint. the fact that we had a p presidential debate take place in a community solely because of environmental justice issue is huge. the fact that we had president obama visit a community because of an environmental justice issue is huge. the fact that the state of michigan has an ongoing investigation because of an environmental justice issue, the largest in their state's history, is huge. so this is a time where we have to rethink what the job we were hired to do is versus what work
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is required from our job. again, i'm someone who was hired to work on poverty. but in order to truly make an impact on the issues you have to think the totality of the issues communities are facing and how inner connected they are. it's a wonderful first step you have come to this event today. i hope that you take this back -- information that was discussed today to your organizations and do something differently. i think we have a tendency to be part of coalitions and meetings and get excited and go back to our organizations and do what we were going to do anyway. i implore you to think creatively about the work required to do your jobs. thank you all for joining us. we look forward at center for american progress to partner with all all of you in any way we can. thank you so much. [ applause ]
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cspan will have live coverage as iraq's ambassador to the u.s. talks about what he sees about the future of u.s. iraq relations. the world affairs council is hosting the program. it begins at 7:00. at 8:00 on cspan chief justice john roberts talks about finding consensus on the court.
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he touches on whether elite attorneys should be the ones to argue cases before the court. here's a brief look. >> is the appellate bar before the supreme court becoming too elite and too ingrown in your judgment? >> you know, i gave a talk before the supreme court historical society 12 years ago. some of you may have missed it. but at that time it talked about that very trend. you go back to 1980, i think, i don't remember the numbers, but putting aside the government's lawyers and the solicitor's general's office there were two or three people who argued more than one case that term. maybe a couple more. now it's routine. the lawyers we see quite often in a single case, one has done ten arguments, one has done 30 arguments. that was unheard of back then.
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it is a change. the bar is more specialized. supreme court acvdvocacy was no recognized as a specialty. arguing before the supreme court is specialized. it's not like even arguing before the courts of appeals. it's good to have people there who know that. and who have done it before. and understand what we're looking for when we ask 100 questions in a half hour as has happened. and understand that although the case involves a bankruptcy statute, it's probably not in the supreme court because of bankruptcy issues. it's there as part of how we view statutory interpretation. it's good those people know that. it's good that they're repeat players just as in any other court. they know they're going to be up there again later and they'll be
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circumspect about how they analyze the record and explain the cases to know. i know i do and i think many of my colleagues also do, sort of miss the opportunity for something of a mr. smith comes to washington moment. where you have the sole practitioners with the battered brief case and you have a good sense of what his practice is like and his understanding of what the court is like. they often do a very good job. it's just so hard these days. you have to spend months focused on the supreme court case. it's hard for a sole practitioner to do that. and it is -- to that extent i think it's disappointing. you lose a little bit of the color of the -- and texture of an argument when it's the same people. although, we benefit a great deal from having experts before us. >> chief justice john roberts spoke at the green briar resort in west virginia. he also talked about diversity on the court.
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see his full comments tonight at 8:00 eastern on c span. i think the day we are to catch up with the 20th century. we've been the invisible half of the congress the past seven years. we've watched our house colleagues with interest, at least i have with interest. the tv coverage of members of our colleagues in the house. >> today as the u.s. senate comes out of the communications dark ages, we create another historic moment and the relationship between congress and technological advancements in communications through radio and television. >> 50 years ago, our executive branch began appearing on television. today marks the first time when our legislative branch in its entirety will appear on that medium of communication through which most americans get their
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information about what our government and our country does. >> they're televising proceedings represents a wide policy. it recognizes the basic right and need of the citizens of our nation to know the business of their government. >> thursday, cspan marks the 30th anniversary of our live gavel to gavel senate floor coverage on cspan 2. our special programming features key moments from the senate floor from the past 30 years. >> i would show to you the body of evidence from this question, do you trust william jefferson clinton? >> we have just witnessed something that has never before happened in all of senate history. the change of power during a session of congress. >> what the american people still don't understand in this bill is there's three areas in this bill in the next five years
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will put the government in charge of everybody's healthcare. >> an interview with senate majority leader mitch mcconnell. >> i'm sure i've made a number of mistakes in my political career. >> remarks by allen froman. watch 30 years of the u.s. senate on television, beginning thursday on cspan. go to cspan.org to see more. a honduran woman with the zika virus gave birth to a baby in new jersey with birth defects. associated press reports the woman delivered the baby through a c section today at hackensack university medical center. there have been more than 500 zika cases in the u.s., all involving people who were infected in outbreak areas in south america central america or
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caribbean or people who had sex with infected travellers. mosquitos aren't yet spreading zika in the continental u.s. experts predict small out breaks are responsible as mosquito season heats up. the director of the national institute of allergy and infectious diseases recently outlined the risk of the zika virus in the u.s. he was joined at the wilson center by google's vice president for public policy and the cdc. this is just over an hour. >> good morning. welcome to the wilson center. we're impressed you managed the metro and the other issues getting into this building. and we're delighted to host or maybe terrified to host a national conversation on zika in the u.s. can we manage the risk.
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i'm jane harmine, president and ceo of the wilson center, recovering politician. and think that this subject could not be more important. overthe weekend in the washington post there was an op-ed by ron clain, including as president obama's former ebola czar, he has a message for this town. zika isn't coming to the united states, it's already here. end quote. puerto rico is already facing a crisis. and when mosquito season picks up, which could be any minute the rest of the country will, too, zika is an urgent threat to american public health. you wouldn't know it from the attitude of my former employer, the united states congress. for too many members, this is just another occasion for the blame game.
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with failures like flint michigan on everyone's mind, i'd have thought there would be a rush to get ahead of the next preventible tragedy. because when these public health crisis blow up, politicians who drag their heels get embarrassed. but much more important, people become ill and some die. to their credit, the individuals on today's panel have been out there on the air waves getting the word out from a range of angles. i'll delighted that they're taking our stage today. susan molenari was one of my colleagues in the house. >> reforming also. >> we have escaped the toxic partis partisanship. she now works with google.
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like me i'm sure she's frustrated our former colleagues aren't moving faster. rear admiral ann shugat. principle director at the cdc has been combatting disease for decades. i remember dealing with you when i was in congress. diseases like h 1 n 1 ebola and now zeika. she thinks we could see hundreds of thousands of zika cases in puerto rico and hundreds of cases of microcephaly. let's focus on that. my sixth grandchild was born three weeks ago. and as a grandmother and as a parent, i can't imagine what it must be like to have a child boe born with microcephaly. we have to do more to get ahead of this. when ann says zika is scarier than we thought she speaks from
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a long medical background. the same goes for my friend, dr. anthony fouchy at nih. he's a giant in the field, i can't tell you how nervous i was to hear him say, quote, we can't pretend to know everything we need to know about zika. end quote. we're grateful again to nrp's global correspondent for moderating such an important conversation. we hope it can be a wakeup call for this town, especially for those folks one mile away on capitol hill. the senate and house have passed different zika funding packages. they actually have done something. but now they have to hold a conference to bridge the gap between the two measures. i can't image congress is so busy it can't find time for this priority. i don't know when they'll
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conference, but tonight wouldn't be soon enough. in the meantime, please join me in welcoming our distinguished panel. [ applause ] >> thank you all for coming today. i'm hoping this is going to be a conversation amongst all of us. we'll get to q&a at the end. if you have questions, think about it. we'll pass the microphone around and try to get to some of the questions you have. just on the amount of interest you are gauging that by what you're seeing in terms of traffic, number of people who are searching about zika in the u.s. i looked at some of the data that you guys are pulling together and what are you seeing? it seems like you're seeing a lot of concern out there. >> that's for sure. first of all i want to thank the wilson center and my dear friend jane for bringing me together with all of you to discuss this issue. anytime i get an opportunity to
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even be in the orbit of dr. fouci i feel blessed. thank you for giving moo ethe opportunity. google if i could back track a little bit so i can put some of this in context has decided about a little over a year ago to work to try and get our arms around zika. now this initially started not in the united states because so much of the attention when we began this project and our partnership with the cdc and nih was when we were focused on other parts of the world, particularly in some places where we have very large employee base like brazil. what google did at this point we have three main components of our global -- very quickly -- product integration on search and awareness campaigns. what we do on that is working with groups like unicef we try and predict -- we do this for over 900 health conditions people go directly on search and now we're trying to provide more
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information in over 17 languages on what zika is, how to detect it. systems, how to deal with it. how to prevent it. an overview of the virus and a public health alert we keep updated from the world health organization. we do that on search. on youtube, we've partnered with content creators across latin america, including sesame street to get the word out via their channel and subscribers to provide information on controlling the spread of zika, content in spanish and portuguese. we've mapped global interest on the zika virus starting in october of 2015. highlighting the time line from when zika became a global epidemic. we've given over a million dollars and we can talk about that, engineers i can get deeper into what we're doing. on the day-to-day. but to answer your question then, knowing that's the kind of
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information we look to compile, right? that's what google does. we try and order the world's information. so the concern around zika now is really clear. we've seen as of march since november a 3,000% increase in searches. a lot of times google searches are very predictive of what's going to happen. i think both of my partners on stage will tell you we work with them with flu trends when people search ant histamini-histamines deal with a high fever. we can help the government figure out flu trends. our guys could tell you they could see the beginning of a housing crisis. people started to see this amazing burst on the scene of people trying to figure out how to get second morgtgages. now we started to see this amazing growth -- >> 3,000%.
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>> just from november to march in terms of people searching. that is a dramatic increase. i dare say that most of this comes from real intense concern. >> that's what the big issue is. people are concerned. and i would like to send it over to you. how prepared is the u.s. to deal with this? we're going into the summer season when mosquitos are about. the disease itself and that concern that people have. >> i need to say we're not starting at a good place. we used to have a lot stronger mosquito control and mosquito awareness. really the surveillance for where the mosquitos are and the resistance patterns they have. we're really -- have a patchwork nation around mosquito capacity. the state health departments, local governments are really concerned and are working on this. but we absolutely need resources to get ahead of t. this is the season when the mosquitos are coming. and so we really have worked out
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plans of how to be ready and what to do at each step of the way. we need to build that up. we have prepared the labs across the country. cdc developed new lab tests, shipped them out to the states and cities and a number of ort countries around the world. but those are new lab tests that don't work as well as we would like. and so we also need to get better diagnostic test developed that will answer more questions than what we have. >> at the beginning of this, there wasn't a definitive test for zika, was there? everything was getting sent all the way to your lab in atlanta, is that correct? >> that's right. i mean, the cdc developed lab tests based on the 2007 yap out break of zika before we knew it was related to birth defects. but, you know, the virus itself can cause no systems in four out of five people. one person will have systems that are relatively mild, fever, joint pain, red eyes. really a rash that's kind of itchy. not very specific.
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you do need a lab test to know whether it's zika or something else. and the lab tests don't really give you a perfect answer every time. they have to be collected at certain times. that said, we're doing thousands and thousands of tests every week to get information to families so they can plan. >> we were talking just before coming out here, i was asking you how many pregnant women are there on an annual basis. you know, i have two children, a lot of people have gone through pregnancies, it's a very nerve wracking time for people. you think about the number of women who will get bitten biy mosquitos this summer. is the healthcare system and the capacity there to manage that concern? >> you know, every day about 10,000 babies are born. and with zika, if you've come back from an area that's -- where the virus is spreading and you're pregnant. we are recommending you see your healthcare provider, that you get a test in the first
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trimester and again potentially later. but that you actually understand whether you were exposed and got infected or not. >> we don't know yet whether be developing normally, and so we really need to be able to follow these babies longer term. last week we announced a new tracking system. and we hope to be following women and their babies longer term so we can understand and give good information to families about what to expect. as you were saying, what we know about this virus is pretty concerns. the microcephaly concern, these babies may never walk, talk, feed for themselves or care for themselves. their families are affected for life, their siblings, communities, we want to prevent
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that kind of problem for families, but we need to know more. >> where does things stand in terms of a vaccine in terms of this cries behind us. with zika with what we have done with rubella. some people may remember in the 1960s, there was considerable risk, about congenital rue bea babies were born in the united states, and the rubella vaccine was really originally directed to women of child-bearing age. the way you get women of child-bearing age, you vaccinate everyone when they're children so they wind up being protected. the good news is we have made successful vaccines against other flavi viruses. others fever are yellow fever, dengue and west nile. conceptually i don't see any scientific road block to developing a vaccine for zika. in that regard, as soon as we realized we would have to put a full-court press on this, we started working on a zika vaccine.
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we have done it with the kinds of technologies we have made out successful vaccine. we have a list of about four or five vaccines that are at different levels that we can move them from preclinical into phase 1 study to see first if they're safe. the big thing about vaccines, the most important thing is saved, because ear giving it to hundreds of thousands of normal people. so we have several candidates. the first one in the queue may not necessarily be ultimately the best one, but the first one in the queue was going to go into a phase 1 clinical trial for safety, and if it induces
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the kind of response you would predict would be happy. we'll do it here, including at the nih in bethesda. we should know by the end of '16, 2017 whether it's safe. if that's the case, then we'll start what's called a face 2-b large multipatient trial to determine if it works. the thing that confuses people
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about timetables, because i always get asked the timetable. we know when it's going to start, we know when we'll get that early data. how soon you get efficacy data depends on two factor, the more effective a vaccine, the quicker you know it works. the second important factor is how many infections there are in the community at any given time. if there are still as many infections in the first quarter of 2017, as we're seeing now in brazil, colombia and puerto rico, we could know if the convenience weeks by the end of 2017, beginning of 2018. if the infections go down, which is good news for the public health, it may take a couple years longer. that's what happened with us, with ebola. we had a pretty good vaccine, and as the cdc and nih, they did it in sierra leone and, as soon
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as the vaccine got going, all of the infections disappears. we kind of feel it's a good vaccine, but we haven't -- >> if you look at the violent outbreak, philippines, and even in cape verde, they believe it's peaked at the moment, it's quite possible we won't have a vaccine until after we've had a peak in the u.s., if history -- is that right? >> be careful when you say peak in the united states, because we don't fully expect -- we're going to be prepared for everything, but we have travel-related cases in the correspondent nenl case, over a 800-plus more in the puerto rico and the territories. we almost certainly are going to be local transmitted. so we need to get ready for what the public and press response to that will be and local transmitted will be where someone never leaves the continental united states and gets infected. we know fairly certain we'll see it because we saw it in florida and texas.
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the critical issue is how to prevent that from becoming sustained and disseminated. i believe if we do the kinds of things, we can prevent it from being real disseminated outbreak, but we need to be action-oriented to do that. with regard to vaccines that a population would use, i think it would likely be in those countries in which you have a degree of endemicity, that it doesn't just come and disappear. dengue has been in the caribbean for a -- and it hasn't disappeared. it's still a problem. so i don't think it will disappear after one year. >> we had a story on our air this morning about people collecting mosquitos in houston and looking at some of the mosquito control programs there. is there all across the u.s. people where u.s. are collecting -- or is it very
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patchy? tell us a bit about what it's like in terms of the monitoring for zika virus out there, especially across the southern gulf states? >> much of mosquito control efforts are local, and so they can be, you know across the board in texas, from one county to another, what the capacity is. we're intensively doing mosquito surveyian and control in puerto rico, trying to understand where are the populations and hot spots are the mosquitos resistant to certain insecticides and what works in terms of reducing the aims and the density of the mosquitos. across the southern states it's variable. we have a summit in atlanta, where about 30 state leadership teams came to atlanta to talk about. what were they doing? what could they do? could they learn from the best practices in some of the other jurisdictions? we know there's a lot of room
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for improvement. there's some excellent programs, but across the street it might not be as strong as wherer, and of course the mosquitos aren't following the district lines the joy that's the principal one that spreads this virus is really difficult to control. it is quite hardy. it can over-winter, very little water is needed to maintain it. bites during the day and the night. it's not the mosquito that you notice is biting you. it can be very subtle. so it can be inside and outside the house. so in puerto rico or some of the southern states where people leave their windows open to get that nice breeze, they can have mosquitos inside and outside that are quite difficult to control. this is an intense part of our work right now, really evaluating a lot of different
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efforts to understand the best strategies. >> do you also have a strategy if you start getting local transmission? also just to deal with public reaction. >> the implications are large, but issues about the blood supply, in puerto rico we shipped blood there about six weeksant we can't get adequate screening tests to screen the blood. this is an area where the state and local governments are really intensively trying to prepare, and where the resources are sorely needed. we recommend if you come back from the caribbean or puerto
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rico, you should repellant for about three weeks, you might have picked up the virus silently, and if you get bit by a mosquito in your own area, that mosquito could pick up the virus. that's not intuitive, but we do recommend that. in atlanta the airports actually have a loop that reminds you to do that. of course if there's more wand one case, is it the same household or nearby? these are drills the states and locals need to do now. we need to surge the lab testing, get the communication out there, we need to dural a lot of work to do. >> do you have any sense of how likely it is how likely is it that someone is has gotten infected and doesn't know it? >> we know that over 500 people have traveled back from zika affected areas to the 50 states
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and developed zika infection. we probably have many more than that, and there would be people who see, and through the detection efforts, so we probably have had thousands and thousands of travelers. we know of over 500. there's issues with probability, but the reality is one bitings and if you're pregnant, your baby could be harmed. that's just a phenomenon problem to be working on, and that really motivates us. cdc has over 1,000 people who have been part of our response already, and there are actually 11 different centers of cdc are involved, because it's birth defects and mosquito experts, infectious disease folks, so the probability only gets you so
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far if it's your pregnancy. >> the other issue that ann was saying, it is counter-intuitive, you come back from brazil or puerto rico, you think, i made it, why should the put on the repellant. it's complicated and confounded by the fact that it's sexually transmitted also, so men who return from -- it's sexually travel to our knowledge from men to women, but not from women to men. we've been able to demonstrate not only the presence of the virus in the semen, but also the documented case of sexual transmission. it's always a man as a transmitter, that when you come back from a region it's well delineated on the crisis website. if you come back from the region, and you have a pregnant wife, clearly if you're infected or even highly suspected, use a
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condom for the duration of the pregnancy. if you don't have known a known sexual partner, if you have a documented infection or high suspicion, you should either refrain from sex or have sex with a condom for six months. if you're down there, don't have any symptoms and you figure maybe i'm one of the 80% that don't have symptoms, you should use safe sex abstinence. that's a difficult message to get across to people. you can see that, i go on vacation and now i come home and -- it's not an easily acceptable, but it is confounding if you think in terms of how it can be spread. being infected, get bit by a mosquito which bites someone
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local, which is a local transmission, but -- are we getting more information about exactly when people are at risk? is it possible that if you were infected just before you got pregnant or if it was the end of the third trimester, are we getting more -- >> there are cohort studies and case-controlled studies, the cdc is doing one, we're doing one with the national child -- of 10,000 pregnant women in a study that's call the the zika and infancy and pregnancy study. like any virally transmitted disease that results in congenital abnormality, the first trimester is always the most vulnerable. but we have concerning evidence that there has been transmission at a time beyond the first trimester, well into the second trimester and beyond we now know this we don't know how often that happens.
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if you have a zika infection, what are the chances? so the studies at the nih and cdc and collaborators are doing are so important. the other kind of study, which is ongoing, that we really want answer toss is about what the virus does in the body, as tony was saying, this persistent virus is why we have to have this is complex guidance around sexual transmission. we've been seeing survivors start a flare-up. it's up to 18 months. it's been documented my goodness. the beginning of an emerging infigures is it's the uncertainly that causes concern. >> susan, i wondering if you're see peep drilling down to what
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they're searching for, are you getting some beyond people who are freaking out? again why i'm here. what we're seeing, when people start to look, they're looking deeper, they're asking more questions, and it is mirroring the epidemic. when you take it past a -- and so that's why we're at the point where we're starting to shift some of those engineering to the
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united states, and to try to get a handle. out to in terms of our concern, our knowledge, so now very recently we have put of knowledge panels and directed people to places that they can go, but definitely the intensity and click-throughs have just grown. particul particularly here we can see it in the united states.
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>> the fact that it is mosquito born, do you think it adds to people's concern about it? >> i think it adds to a concern because it is very frustrating in how you can control mosquitos when you have a mosquito species that is particularly recalcitrant to the things we do. so that adds a dimension of frustration because there isn't a lot you can do. you can try your best cleaning up the environment, but even with that history has told us this is a -- it's a whole new venue of transmission, which is quite difficult to contain. >> are the inside insecticides working? are you getting some resistance too?
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>> this is going to be variable. there is one insecticide that works from our testing. there's one that works throughout, but one of the issues is how to deliver it. what are the best ways, inside, outside, adults, lar va, there's innovative traps that have been developed that are being used. i think there's a lot of different approaches. people are naturally questioning is it okay if it's going to kill a mosquito what's it going to do to me? there are procedures to make sure the products that are being used in and around homes will be one with that safety -- or the benefit-to-risk ratio will be on the benefit side, but it's an area where understanding the full range of options, and
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investing in some innovation is very important. you probably heard about some of these innovative strategies for mosquito control, the genetically modified mosquitoing, the bacteria, i think it's exciting to have several new avenues being evaluated, but in the meantime, better they're really ready for massive scale up. giving that so many of the cases we're dealing with are travel related. i have to ask the travel question, everyone wants to know if i'm going to go somewhere, can i protect myself? is it possible to go to, say the olympics in brazil, and protect might haveself? and come back and be fine? >> of course you can. now is 100%. first of all, to reconfirm what we've been saying if you're pregnant, might be pregnant, don't go to an area in which there's a local outbreak. if you do go, there are thing
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can you do to protect yourself. there seems to be she reluctance to use insect repellant. the approved repellant are safe, safe to use, so you should hesitate. obviously when you're in a country that, there's not a lot of screens, sometimes it's difficult to protect yourself in that regard. it's easier here in the consequence in this united states, we do have that, we do have air conditioning, we do have screens, but proper dressing, keeping it in a place that is not mosquito friendly, mosquitos don't like air conditioned rooms, and using insect repellant is a way to help protect yourself. >> i would love to open it up to questions in the room tell us who you are.
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just wait until you get the mike u. >> thank you so much for all your expertise i'm a senior associate, with the innovation program, so we've been looking at this issue for some time now. you know, this -- the way you frame this problem seems to be really about uncertainty management and knowledge translation from expertise to the citizenry. would you u.s. consider two strategies that have been used in orange roans? europe and in latin america? one is the use of genetically modified mosquito that has been used in brazil and in other places? and then could we harness the power of the citizenry, of
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citizens? could we harness their power to better -- to improve in monitoring of mosquito pop population? and to distribute -- can we think about, you know going further, using citizen signs using really the power of citizens that understand better what the problem is about, to actually innovate? >> yeah. >> maybe i can start. i think that the issue with the genetically modified mosquitos, there are some evaluations being considered. sew the communities are considering whether they want to go that route or not. in terms of the citizen engagement, incredibly important. this is an area where everybody has a role to play.
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i don't know that i would say for diagnostic test distribution, i think at least in the u.s. we have a pretty good diagnostic test distribution, but i think in terms of source control, in terms of making sure you cleaned up the neighborhood, cleaned up the back yard, got rid of the standing water, the satires and stuff, clean up the garbage areas, but also in terms of the information. so that issue of pregnant women making sure they know what they need to do to protect themselves, i do think that question of mosquito monitoring, there are probably innovative weighing they could be tapped into that.
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there's certainly a science to figuring out which kind of science it is and is it resistant or not? i think there's more power of communities. that is part of what is being developed for about weathero rico and i think the southern states is a good idea as well. >> i wonder, susan, is there some way to get people to move beyond just searching? i don't know whether there's some way to take that interest that's there and channel people to take action the way she was asking. >> i was thinking about that as you spoke. i think one of the things we have done successfully in latin america is using our youtube channels and partners, because you have an ability to deal with the subscribers, and it's not a one-shot message, and you're reaching so many populations, and the world health organization in terms of how to get that message out there. the knowledge panels are written particularly here in the united states with the help of our health partners, because that's not what we do. and so whenever we get the opportunity to get a message from these amazing individuals, we will put it on our health panels. so as we were here, i was just thinking about the memo i'm going to send to mountainview. this is why jane invites me here.
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it's not what i say, but what i do after i leave, to talk about some more proactive things that people can do in the united states in particular, and maybe involving some more less traditional media outlets to get some of this conversation going. >> one of the things that would help in areas where there's a lot of circulation like puerto wrecko is installing screens, so all of the schools or clinics that need these screens, it's a humungous effort, but community volunteer and engagement may help. there are some private sector companies helping think through the product availability one day you can help with screener nets ands available. >> all the way in the back, that corner over there. tell us your name as well. >> go ahead and stand up. we're not quite hearing you. >> hey, i'm a physician, tropical diseases, and currently studying anthropology. my research has to do with cultural factors, so my questions continue with the idea
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of people's behavior in prevention. that deals with different cultural conditions that would, you know, frame the way that people react and makes discussion of the disease. >> i can say there has been some involvement of that in some of our field work, in particular really focusing on planning for the communication or outreach efforts, where we have done focus groups or informed interviews on a lot of women in puerto rico to understand what are their concerns, what are their practices?
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what are they interested in? so -- but there's probably a lot more that could be done. i'm not sure about nih's work. >> we're not doing this ourselves in funding it, but our interaction with his our colleagues in brazil, what you want did sorm determinant is very important. we're finding the ability of people in a particular region to have even any control of their risk is very difficult. like in many diseases, poverty is a really bad thing, if you live in an area where you have still water that you can't get rid of, you have environmental neglect, which leads to the breeding of mosquitos, makes it very, very difficult. the people who at least in the beginning of the emdemocrat that suffered the most were the
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people who lived in the very poor northeastern section of brazil. states there, was really the epicenter early on. we're seeing it more diffuse now. it had nothing to do with social, behavioral issues. it had to do with the unfortunate poverty circumstances that they were in. >> take one down here. yep. with the beard. here, the mike's coming. >> thank you. herb rose. >> i'll get to you next. >> i have a quick question. most of the news stories have been directed towards encephaly and the effects on pregnant women. i'm wondering if it affects another demographic, neurological diseases that would affect another part of the population. >> you want to talk about that. >> no doubt we're seeing, we don't know the exact incidents of it, the paper published 24 per 100,000 infections that's not necessarily the most accurate number.
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we need to do more cohort studies to follow prospectively but the relationship to zika infection is pretty clear. we have seen individual case reports and we've got to be careful because we see this in almost any viral disease. there are outliers, like a case of myelitis in a 17-year-old woman, a case of encephalitis in an 81-year-old man, four cases of acute encephalo myelitis, there doesn't seem to be anything of any significance above and beyond guillen barais
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condition. what we look at as microcephaly, if you look at the babies microcephaly may be one reflection of developmental abnormality or direct destruction of developing tissue but the babies as you follow them have a variety of other issues. retinal, eye problems. deafness problems and a variety of other things, so i think when we do finally get the full scope we're going to see that microcephaly may be just the most obvious, gross manifestation of the effects, and there are a lot of other things that we'll be seeing that will be detrimental to the developing fetus. >> did you want to add? >> in terms of the neurologic complication of zika in a nonpregnant setting, we've made recommendations for avoiding travel if you're pregnant because we have enough data to say the risk is high enough, you
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know, in terms of the concern about the birth defects. we don't know of factors that make it more likely that somebody will get neurologic diseases following a zika infection and based on what we know now we don't know that the risk is so high for everybody that nobody should go to these places. in general, it increases with age. the older you are, the higher the risk is. but it's a pretty uncommon condition. the full study of the full spectrum of zika spectrum will help us understand whether there are predictors that would help give some warnings to people. >> i wonder if zika is showing us some overall weaknesses. is there the potential that another virus that's also mosquito-borne could be creating diseases at a much higher rate than what did you say 24 per 100,000. is it showing us that there's the potential there in terms of the way that diseases spread that something that could be
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even far worse than zika has access. >> it may not necessarily be happening now but you said is the possibility of other infectious diseases. yeah. they're going to keep coming. at the end of 2015 i was giving talks as was anne and tom frieden at the end of the ebola epidemic you can be absolutely certain we'll see another emerging infection in some time and no sooner did i catch my breath than zika came. we'll continue to see emerging and reemerging infections. that's just the nature of interaction between microbes and humans. sometimes you get something like hiv-aids and you have things that are little blips that are
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curiosities. you have things that come and then good public health measures suppress them like sars. we didn't have a vaccine for sars but very intensive classic public health measures suppressed them. and you getting? that's devastating to a region like ebola and now something that's causing concern in the americas, but beyond the americas because i can tell you the europeans and people in africa are quite worried that this is going to be seeing what we're seeing in the americas we're going to see there, so, jason, you're right, there's a possibility that we'll see a lot more of this. >> between the way that we live and the way microbes evolve there will always be new ones. this is more concerning than a lot of them because the permanent harm that babies can experience but we know that there are more of them. there are some circumstances
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that let us know it was happening. a very dense population in northeastern brazil. good system to -- of surveillance to detect it wasn't just dengue or chikungunya but it was zika causing the fever. and the alarm was raised but we need every country to have a strong frontline public health system where they can detect new problems and react quickly and prevent catastrophe. if we'd had a strong public health system in guinea and sierra leone we would not had 28,000 people suffer from that disease even in the u.s. where we have a good system we weren't as ready as we needed to be for the importation. between human behavior and the mosquito concern and then these pathogens that just really adapt and evolve and spread, we know we have to be ready for multiple outbreaks at the same time. >> i'll go to this guy right here who i was calling on last time. tell us your name. >> thank you, jason. gavin mcgreggor from hershey medical college penn state university. recently come back from a number of countries in south america
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doing risk assessments for zika at hospitals and laboratories and doing the same thing in the u.s. but at the state and local county level. what's really evident from people that i talked to is that zika's become a gender nightmare. the burden we put on women of reproductive age, whether they can protect themselves from mosquito bites or decide when and how and when they're going to have sex they're not empowered to do that. we've seen a lot of worried will in the countries i went but also in the united states and the worried well are turning up i'm pregnant, do i have zika. we're talking to a lot of physicians and nurses about the counseling and mental health needs for the families, the grandparents, the community. and i put the analogy to other programs that we're familiar with like malaria, national
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campaigns, we've gone to schools. is it time for a u.s. national zika, a united states national zika campaign so that we do mobilize the community and we do address the needs and we take that burden off just the moms? >> you know, we do think that everyone has a role to play. and i know that pregnant women have so many things, you know, we're telling them don't do this and do do that and, you know, often they can feel like they're in this alone. but i think the idea of protecting our communities against the harm that zika can cause is very important. but we have to remember that the risk is really different, you know, in minnesota than the florida keys than puerto rico. and so right now we are launching a communication campaign in puerto rico to really make it a whole community issue with billboards and bus signs and the full works partly funded through the gates foundation because we don't have
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a lot of money yet. but i think the issue of this is not any one individual's problem, it's all of our problem, we need to work together and we need to not put even more pressure on one person. the other thing to say is that in puerto rico two out of three pregnancies aren't planned. in the u.s. one out of two isn't planned and if you're not planning to have a pregnancy, you know, having access to safe contraception is a good thing. because having that access would be important if you're not trying to get pregnant since there's a new threat to a pregnancy that you have to be concerned about. >> speaking about this issue of it not being as much of a threat in minnesota, is there more clarity on the transmissibility versus -- because the way that the two mosquitos if you look at the map of them it's very different. so, do people all up the eastern seaboard need to be worried about this.
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is there more clarity on that? is it mainly one mosquito that we're worried about? >> it can be transmitted by one, but in situations where there are overlap, but one is a dominant vector for this disease. for a number of reasons, one mosquito focuses on one species, the human. other mosquitos get distracted. they bite animals. we dilute it out. but one has one objectives, bite humans and only humans, indoor, outdoor, morning, noon, night. whenever there's a competition, the human one is the one you have to be worried about. >> one down here. >> hi, my name is erin kenny and recognizing that i'm speaking to public health professionals and business representatives, i'm curious if you could reflect on the media landscape associated with zika and public health threats that are popping up in the past generally. how can we learn from the domestic media frenzy related to ebola and how does increased attention to the public health threats help or hurt domestic and international response
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raising the political profile of health threats, helping or hurting, if you could just speak on that. >> susan, do you want to try and tackle that one? >> no. >> no. >> i mean, i think, you know, we have the -- the comfort of google at least where people have to come seek us, right? so i think probably what we're talking about here is not causing panic in areas where there need not be panic. certainly i was pregnant twice and, you know, went through anxiety every day for everything that i caught or did or damaged, you know, and so to make sure that we don't -- that we arm people with knowledge but not produce undue panic and make sure. i think that's one of the things that google is helpful because people who do have concerns will be brought to a series of levels particularly now in the united
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states with these knowledge panels that are going to be updated all the time. so, those people who are concerned who may be at risk are going to be getting the information at the same time working with these individuals so that when we start to see mappings that mean that we and the rest of the media have to be more aggressive. we can see those trends. >> yeah. i think the media has been pretty good about not being overly hysterical at all about this. in fact, i think they've been really -- i've been pleased with it. so, i don't see -- i mean, there's always exceptions, but for the most part there haven't
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been stories or headlines that have been egregiously misleading about threats that aren't there. usually -- i mean, there was a situation, and it was really, you know, isolated during the ebola outbreak when there was this paper that came out that said that ebola is a virus that's mutating and the next thing you knew somebody who shouldn't have said it, ah, mutating, it could be respiratory borne. the next thing you knew there was the concern that all of a sudden it would be respiratory borne. i didn't like that. i thought it was a little bit over the edge there talking about that when there was no evidence whatsoever. but i wouldn't blame that on the media, but that's something that came out in the media that i think misleading. >> but that's really the challenge, it's informing and not alarming. >> exactly. >> i do agree i think the media
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has been responsible and frankly this virus is scary enough on its own, you know, you don't actually have to hype this to have a virus that a mosquito bite can infect you and you can have a baby that's harmed forever. but i actually think we have another problem that we just get fatigued with the new problem. and, you know, tony and i will be working on something for years but the public moved on years ago. and we can't fix this overnight. this is going to take time and a lot of work. and so whether it's the media or some of the social media, the attention to it can't fade before our response is strong and we really need to not hype this but find a way to have persistent attention and focus and in public health and research, you know, we're really activated. we're working very intensely. but how to get the public support without alarming people is a challenge. >> time for a few more questions. let's take one way in the back on the right there. again, tell us your name, please.
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>> i'm an ob/gyn at the george washington university and it's going to be a long summer for us with every woman coming in with a mosquito bite. is there general advice you have for that? i appreciate that. >> oh, boy. >> thank you so much for what you do. you know, i know in ob/gyn you're always counseling because, you know, people want to take care of themselves. they want a healthy baby. and, you know, there's probably many other things besides the insect repellant that are important for women to do during their pregnancy. but we hope to have better and better information that can help put the risk in context. right now we don't have any local transmission in the 50 states. the only part of the united states with local transmission from mosquitos is the -- puerto rico, u.s. virgin islands, american samoa, the territories.
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so, really right now the focus is travel risk. and having that health department come out and assess the travel associated circumstances. but good luck with the summer and e women that you'll be seeing. >> what's going to happen is that women -- the first message you give to your patients is that if there's no local outbreak, there's very little chance that a mosquito bite, that that person got in their backyard in bethesda is going to get them zika. you never say zero but it's almost zero. if we do have local outbreak which as i mentioned just a few minutes ago i think there's a reasonably good chance we'll see it likely on the gulf coast the way we did with dengue and with chikungunya, then it's not going to be unreasonable for someone to come into your clinic at gw and say i was sitting in my backyard and i got bit by a mosquito and i know there's zika in florida and texas, so how do i know that mosquito, that's going to be the problem because they'll be demanding to have a
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test for zika. and when you have the demand for tests, there's two types of test. there's a test am i infected now. a pcr test that will tell you whether you are actively infected and then there's one that if you got infected three weeks ago the question was i infected and that's the test that we're working on to get a great deal of specificity to make sure you don't confuse it with something else like having been vaccinated with yellow fever or if you happen to live in the southern part of this region to have had dengue. so, that's going to be a
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challenge and that's the reason why the cdc to a great extent and nih to some extent were working on getting diagnostic that's highly specific and highly sensitive to be able to answer the question of somebody was i infected four weeks ago because i'm eight weeks pregnant now. that's the question. >> when you look at the idea of are we prepared as a nation for this. we were talking earlier and what was the number of tests you said you could do a week on pcrs, 23,000? >> that's what we're doing right now. we have capacity for that. >> and potentially millions of women who are pregnant. >> one of the things we're -- we have a couple tests the fda has
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given emergency use approval for and there are two companies that have also recently gotten approvals i believe. i think we really want the commercial sector to step up with this and that's another reason why i think the resources are important, if they see it as a real commitment there will be a real commercial interest in doing their part. ideally we get better tests and ideally we can scale even further with the tests we have right now. >> i don't mean to play up the doomsday scenario of the scenario you were playing out, if you start to have local transmission, it's not just the woman that was bit and my husband works as a roofer and do i need to be concerned whether or not there's sexual transmission. i do think if we start to get local transmission a lot of this would -- some of that will really ramp up in terms of the concern. and how that gets managed i think is going to be really the hallmark of how we deal with this.
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>> you know, it's very interesting because we have faced this with other perceptions of risk, you know, with the anthrax letters people were asking me whether i actually picked up the letters that came into my house. >> i used to keep it in the garage. >> a variety of things in the early years of hiv/aids whether or not you could get it by casual contact. the issue of relative risk. a risk may be a new risk, namely the risk that the patients perceive that they have, the risk may be far, far less than the risks they accept every day of their lives but they're risks that they're used to. new risks even if they're much less risky than the risk of getting on the beltway every morning which is probably more risky than anything your patients face, there's the extra twist with this.
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when the risk is to your developing baby, that trumps everything. >> absolutely. >> that's really the thing that's going to transform people's perceptions of risk because that brings it into a whole new category. >> totally. well said. well said. >> i think we have time for one more question. >> well, so, what a superb panel, first of all. exceptional people who know how to tell it straight and not scare us to death, although as a grandmother, now i'm scared for the yet unborn pregnancy -- pregnant, you know, grandchildren my children will have. but my question is about congress. i started there. susan, i know you want to answer this question. do we need these bills that are -- have been passed by either house -- by both houses, do we need congress to step in? what do we need from congress? and how do we make that happen in this toxic, partisan town? >> well, i guess my initial reaction would be that even though this town is extremely partisan one would hope that an issue like this would certainly not be partisan. doctor, you know, so when you were talking about the difference in this, which really is that emotional and societal difference of taking responsibility for something and making decisions to deal with your unborn baby or, you know, your child is something that i don't know that we've, at least in my lifetime experienced. >> right. >> with regard to the level of concern and the generations after. the repercussions for generations after. so, it is saddening that this is
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one area. because what i've heard you say the entire time is this a significant matter of resources to get it done well and thoughtfully. >> but, jane, the answer to your question is the president asked for $1.9 billion because we need $1.9 billion. he didn't ask for slush fund. we need it. so, what the cdc is doing, what we're doing, what other agencies are doing we are now using money that we would otherwise be using for other things. you can only do it for a certain period of time. you can't go beyond that. then you have to start paying it back and you have to stop doing things that are also very important. we really need the congress to act quickly. and taking money from the ebola account is not the solution. it's just not. because as anne said we're still seeing this outbreaks of zika that if we lay our guard down the cdc is doing how many a week, thousands tests? >> 10,000 a month. >> a month. we can't stop doing that. short answer, we need the money the president asked for. >> seems like it would be a safe political vote, too, i think. >> i think it's a fairly good place to end.
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bring it right back to where you started. thank you all for coming. and thank you all for being here. >> thank you.
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this evening c-span will have live coverage as iraq's
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ambassador to the u.s. talks about what he sees for the future of u.s./iraq relations. the world affairs council is hosting the program in washington, d.c. it begins at 7:00 eastern. here on c-span 3 at 8:00 eastern, we're going to show you some of the "american history tv" programs normally seen only on weekends. tonight the 50th anniversary of the vietnam war that lyndon johnson presidential library held a retrospective on the conflict including a discussion on politics and music as well as foreign relations after the war. "american history tv" prime time tonight at 8:00 eastern here on c-span 3. and on c-span at 8:00 eastern john roberts talks about finding consensus on the court. here's a portion of what you'll see tonight. >> mr. chief justice, you mentioned the unanimous nature of the brown v. board of education decision 62 years ago.
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how would you describe your approach to consensus building on the court and how would you compare it to the styles of some of your favorite chief justices in our history? >> it's interesting. it was a great benefit, but there was another side to that. they left a lot of things undecided. you had a generation of litigati litigation, where does the obligation apply and on what basis. so it was unanimous and that was a good thing and i understand chief justice warren's reasoning, but it's subject to criticism. even if it's going to be 7-2 or 6-3, let's get some of those things resolved so people know how to implement this. all deliberate speed, what does
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that mean? so there are pluses, there are minuses. sometimes when we have written opinions people have said for the lower courts and they often pay the price for that which is how do we do this and couldn't you have spent five more pages giving us a little more guidance. i try to achieve as much consensus as i can. that's not something i can do on my own. we koind of have to have a commitment as a group to do that. i don't want to speak for the others, but we spend a fair amount of time, a little more than others maybe in the past talking about things, talking them out, which sometimes brings you a little bit closer together, but it's been subject to some criticism that it's just sort of can put things off and say let's not deal with this issue.
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maybe in five years you get another case where you have to and some people think that's bad. i really don't. it has something to do with judicial philosophy u. i think we should be as restrained and only decide issues when it's necessary to do so. i think that's part of how i look at the job of a judge in our system. so how it relates to others, i'm not quite sure. i think big chunks of our history, the idea wasn't clear you could because everything was unanimous and i u think that had a lot to do with john marshal just the way the force of his intellect and his nature. the first big decision he made is when we get to washington, we're going to live in the same boarding house. they had a lot of responsibilities outside of washington so they didn't have permanent residence there and they very much functioned as a group. if you look at some of the history, it's not because
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marshal imposed his will. there was a lot of exchange. other views were considered and often became part of the unanimous opinion. >> chief justice john roberts spoke at the resort in west virginia. he also talked about diversity on the court. see his full comments tonight at 8:00 eastern on c-span. c-span's washington journal, live every day with news and policy issues that impact you. on thursday, we're live in texas on the u.s./mexico border to talk about trade issues affecting the region and the country. san antonio trade reporter discusses the flow and volume of trade across the border. also texas congressman henry joins us to talk about how trade benefits the country. then bob cash, state director
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for texas fair trade coalition and the nafta critic looks at how the trade deal moved jobs from texas to mexico and how that hurts mexicans as hurts m. watch washington journal live from laredo, texas, 7:00 a.m. eastern thursday. join the discussion. citizens have got to feel that their vote matters, that their voice matters, and whether they can not spare a single cent to help a person running for office or whether they can write a big check, that their concerns, their struggles will be listened to and followed up on. >> sunday night on "q&a," wisconsin senator tammy baldwin talks about her career in public service and wisconsin political history. >> bob lufallot, sr. hoelped
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shuffle the change whereby senators were not appointed by the legislatures but demanded elections. so i guess those -- i don't know if it was the first, but the idea it wasn't going to be the party bosses who nade the decision of who the nominees were in smoke-filled back rooms but rather the people who were, you know, going to get a chance to vote in free and fair elections. >> sunday night at 8:00 eastern on c-span's "q&a." federal reserve board member jerome powell now on monetary policy and the status of the u.s. economy. while speaking at the peterson institute for international economics, he said he would not make a decision on voting for or against a rate increase until the feds' next meeting in june. this is about 1:10.
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>> good afternoon, ladies and gentlemen. it's my pleasure to welcome you back to the peterson institute for international economics. i'm adam posen, the institute's president. and it's a genuine pleasure as well as obviously an important event to have the honorable jerome powell, member of the board of governors of the federal reserve system to speak to us today. his topic is recent economic developments, productive potential of the economy and monetary policy, and it is that linkage between the real side productivity questions and monetary policy that i think jay and his colleagues in the fomc and many of us here at the peterson institute are very concerned with. there used to be a very simple
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translation if you thought productivity was better, you would have a looser policy and if you thought productivity was worse, you would run a tighter policy. it doesn't seem to be quite working out that way but also because productivity is doing such strange and interesting things in the u.s. at this moment, so we're delighted to have jay powell with us. just for bio, as all of you know jay took office as a member of the board of governors of the federal reserve in may of 2012. he was reappointed and sworn in in june of 2014 and in theory can serve until 2028. i say in theory not because of any doubts about his longevity or his commitment to public service, it is merely myself someone who gave up after being on the inside after three years a question of sanity. but more seriously in obviously a very fractured political system here in washington with a very fraught appointment process, jay powell has been a
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hero in standing up and staying and serving at the federal reserve under these circumstances and contributing importantly to many debates both on monetary policy and on financial regulation and bank supervision. prior to being appointed to the board jay was a visiting scholar at the bipartisan policy center in washington, d.c., and focusing on federal, state and fiscal policy issues. from 1997 to 2005 he was a partner at the carlyle group and prior to that he was an assistant secretary under george herbert walker bush with responsibility for financial institutions and treasury debt market and related areas. he had previously had a distinguished career in the private sector as a lawyer and investment banker in new york city but after this amount of time we claim him as one of washington's own. i hope that will not be misinterpreted in the press as something scandalous. that's meant as praise for someone who has put public service ahead of personal profit.
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i look forward to jay's remarks. we will have on-the-record discussion and questions following. jay powell, thank you very much. >> thank you very much, adam. it's great to be here today at peterson. and i really appreciate the opportunity to speak here and thank those of you who came out. so, i will begin by reviewing recent economic developments and then i'm going to turn to supply-side considerations such as the level of potential output and the potential growth of the economy. and i'll conclude with a discussion of monetary policy. as always the views i express here today are mine and mine alone. so, on the state of the economy, the u.s. economy has improved steadily since the recovery began seven years ago with growth sticking right around 2%, oscillating around 2% and our economy is 10% larger than it was at its previous peak in
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2007. employment has now passed the 2008 peak by 5 million workers and the unemployment rate has fallen from 10% to 5% which is close to the level that many observers associate with full employment. labor markets remain healthy with employers adding roughly 2,000 jobs per month. so far this year, a pace similar to that of the past several years. and here i will attempt to get a slide. there we go. so, i'm going to go through a few slides as we talk. job growth continues to be substantially faster than the underlying growth of the labor force, so the labor market continues to tighten. despite the strong job gains the unemployment rate has flattened out at 5% over the last 6 or 7 months thanks to a welcome increase in the labor force participation rate which you can barely see in the middle chart there. meanwhile, there are tentative
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signs in a firming in wages seen most clearly in the data on average hourly earnings, the right panel, which are rising faster than inflation and productivity. all told, labor market indicators show an economy on a solid footing. recent spending data, however, has been a bit less positive. growth of personal consumption slowed notably in the first quarter. business fixed investment has fallen for two consecutive quarters mainly but not exclusively because of a steep decline in energy-related capital expenditures. as a result gdp over the two quarters ended march is now currently estimated only to have run at a rate of about 1% on an annualized basis. and that estimate may and probably will continue to move around as more data come in including tomorrow. there are also good reasons to think that underlying growth is stronger than the recent readings suggest. labor market data generally provide a better real-time signal of the underlying pace of economic activity.
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in addition, retail sales were reported to have surged in april. as did consumer confidence surge in may. suggesting that the pause in consumption may have been transitory. more fundamentally stronger demand would be more consistent with an environment that remains quite supportive of growth. with low interest rates, low gas prices, solid real income gains, a high ratio of household wealth to income, healthy levels of business and household confidence and continuing strong job creation. indeed, current forecasts for second quarter gdp are for a rebound of around 2.25%. inflation remains below the 2% target of the fomc with total inflation on a 12-month basis for pce measured at 0.75 and core at 1.5%. both a little higher than a year earlier but still well below target. core, of course, has been held down by falling import pricing owing in part to the large rise
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in the dollar as well as indirect effects of oil prices on core. as recent financial market tensions have eased oil prices have increased and the dollar has weakened a bit on net. so if oil prices and the dollar remain broadly stable inflation should move up over time to our 2% objective. inflation expectations do seem to be under some downward pressure. some survey-based measures are at the low end of their recent historical levels. while i see expectations as reasonably well anchored, it's essential that they remain so and that inflation return over time to our 2% objective. the easing in global financial conditions since mid-february and the associated waning and downside risks are, of course, welcome and in part reflect expectations that the fomc would move more slowly in removing
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monetary accommodation, however, the underlying rinks will likely remain until global growth is on a stronger footing. growth and inflation remain stubbornly low for most of our major trading partners. in china stimulus measures should support growth in the near term but may also slow china's necessary transition from its export business model. meanwhile the ongoing buildup of debt is notable and there's remaining uncertainty about china's exchange rate policy. elsewhere there's the brexit vote, ongoing pressures from f refugee flows into europe and challenging conditions from emerging markets, economies such as brazil, russia, and venezuela. despite, i see u.s. demand growing at a moderate pace with the labor market continuing to heal, inflation returning over time to the 2% objective. the economy is on track to
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obtain stable prices and maximum employment. now, we generally talk an awful lot about demand and that's appropriate. so, i want to take some time here to talk about supply-side considerations which, of course, are more important over the longer term, albeit less to do with monetary policy. so, turning to supply-side considerations. for several years after the crisis, economic activity remained far below its potential and the need for highly accommodative monetary policy seemed clear. as the shortfall has narrowed supply-side considerations like the level and growth of potential output naturally begin to matter more for policy. the tension that i mentioned a moment ago between labor market and spending data is not a recent phenomenon. throughout the recovery period forecasters has consistently overestimated both actual and potential gdp growth while underestimating the rate of job creation and the decline of the unemployment rate.
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to put the blue chip forecasters in the docket, in the dock, this chart shows that for the years 2011 through '15 these forecasters every year overestimated growth and underestimated the amount of decline in the unemployment rate year upon year upon year. this next chart i think is even more interesting frankly and it shows, if you take just blue chip, blue chip estimated the long-run potential growth of our economy in 2007 at 2.9% and that has now declined to 2.1% while also underestimating the more impressive-than-expected decline in unemployment. other well-known forecasts shown here such as that of the survey of professional forecasters, the congressional budget office and, yes, fomc participants, followed
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pretty much the exact same pattern. and that pattern suggests that forecasters have only gradually taken on board the decline in potential in the wake of the financial crisis. output growth can be decomposed into increases in hours worked and changes in output per hour or productivity growth. for the united states much of the post-crisis declines appear to reflect weak labor productivity growth rather than damage to labor supply. and labor productivity has increased only one half percent per year since 2010, the slowest five-year growth rate since world war ii and about one-quarter of the post-world war ii average. for further perspective productivity growth averaged 1.5% during what we used to call the slow productativity period from 1974 to 1995, and it averaged 3% during the tech boom
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decade from 1995 to 2005. so, this shows -- this is the familiar regime change chart which shows that productivity has tended to go through high regimes and low regimes and now it's at a very low regime for the last five years. interesting also that the slowdown has been worldwide. this is all the oecd countries, all 30 of them. and you can see the red lines below there suggest productativity has been lower in this period than in prior periods. so, given the global nature of the phenomenon, changes in factors specific to the united states are probably not the main drivers. i don't know if you have this experience, but i find that people tend to see u.s. economic developments through the lens of u.s. political events. and this i find that when an event has -- when a trend has sort of -- present throughout the globe you have to really look beyond u.s. specific institutional factors. so, what's causing this?
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one factor holding back productivity in recent years has been the meager growth of capital stock shown here in figure four. this shows that capital deepening is at truly anemic levels and in the view of the work we've done at the board that weakness is consistent with and is well explained by the weak recovery in demand. another important factor is the marked decline in total factor productivity or tfp and tfp is that part of productivity that is not explained by capital investment or labor quality and it's thought to be mainly a function of technological innovation, although the story is a lot more complicated than that. it may also be that the broad decline in dynamism in our economy across many measures is contributing to lower tfp. the last thing i'll say about tfp there's strong evidence that
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the slowdown preceded the financial crisis particularly in sectors that use information technologies. this is the work of john furl and many others. the range of opinions looking forward on the future path of productivity growth is wide and historical record provides ample grounds for humility. what seems to have happened is a middle ground position has emerged that probably appears to assume that productivity is still being held down by cyclical factors and the lingering effects of the crisis and as they dissipate, it seems it will move up from .5% perhaps to 1.5%, which would be the lower end of the long run range. that seems to be the general assumption behind forecasts and i can't really disagree with it. so, in addition to productivity the other principal factor in potential output is labor supply which is determined by the working age population, the
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natural rate of unemployment and the trend labor force participation rate. and both the natural rate of unemployment and labor force participation initially appear to suffer crisis-related damage. more recent data, however, are i would say a bit more encouraging. natural rate of unemployment reflects the matching of characteristics that employers are seeking with those of the unemployed with the dramatic labor market dislocations of the crisis it was not surprised to see matching efficiencies deteriorate and many raised their estimates of the natural rate accordingly. but there are other factors like demographic change that have led to a decline and pushed the other way and blue chip forecasters estimate it at 5% which is where it was before the crisis suggesting the factors are roughly offsetting. of course, estimates of the natural rate are famously and highly uncertain. trends in labor force participation add another element of uncertainty.
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participation rates have been declining since 2000 and are estimated to a decliningeral raf 20 to 30 points a year. labor rate of participation are declining in the u.s., driven by population, aging and other longer-term trends such as decline in participation by prime age males. but participation rate fell sharply after the crisis, much faster than its apparent trend, and it's been important to understand how much of that post-crisis decline is cyclical and thus amenable to repair by supportive policies and how much is secular due to either longer-run trends or irreversible crisis related damage. it's been relieving to see the participation rate improve over the last two years relative to estimates of its trend and indeed in some estimates participation is now close to its longer-run trend. still, despite this improvement, the u.s. performance has been
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poor relative to that of most oecd compa countries. for example, we experienced a decline in the prime age group of 2% while most oecd countries saw an increase and we now stand at the low end of the labor force participation for both men and women in the prime age group above italy, but well below germany, france, and spain. you can see here we're at the low end. there are different -- different countries have different ways of calculating labor force participation but i'm not aware and i haven't been able to find anyone who would make the argument that there's a systematic overcounting of participation in those other countries. maybe someone can do that here today. but i would say this is -- this is probably a real trend and certainly if it is a real trend it's not great news. lower potential growth would likely translate into lower estimates of the level of interest rates necessary to
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sustain stable prices and full employment so estimates of the long-run neutral federal funds rate have declined about 100 basis points since the end of the crisis and the real yield on a ten-year treasury is close to zero compared to 2% in the mid-2000s. some of that will be negative term premium as well as expectations. so, to sum up so far estimates of the long-run potential growth of the u.s. economy have dropped from about 3% to 2% in the wake of the crisis, much of the decline being attributed to slower productivity growth. the decline in realized productivity seems to be driven by both low capital investment that's well explained by weak demand and by lower tfp growth. expectations of lower productivity growth going forward are more a function of slower gains in tfp. lower potential output growth would mean that interest rates would remain below their pre-crisis levels even after the
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output gap is closed and inflation returns to 2%. over time our understanding of the relationship between recessions and supply-side factors has evolved. there's a growing body of work suggesting that recessions can leave behind lasting damage especially severe recessions associated with a financial crisis. one recent analysis olivia blanchard being one of the authors along with larry summers suggests about one-third of the time there is no permanent supply-side damage, about one-third of the time there's a reduction in the potential output but not its growth rate, and one-third of the time, a reduction both in the level of the output and the subsequent growth rate. unfortunately as this chart shows recent experience suggests that the united states is in the risk of falling into the latter category. the point being the black line is actual growth and the blue line is pre-crisis trend growth. you can see that not only is the black line not catching up to
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the blue line, it's actually getting farther apart which is just another way of saying that our trend growth rate has declined. i would hope that it would go without saying that economic policymakers should use all available tools to minimize supply-side damage from the crisis. we need policies that support labor force participation and the development of skills, business hiring and investment and productivity growth. policies that are for the most part outside the remit of the federal reserve. monetary policy can contribute by continuing to support the expansion as long as inflation remains consistent with our 2% objective and inflation expectations remain stable. strong labor markets do seem to be averting some of the damage that might otherwise have become improvement. reducing the natural rate of unemployment. potential workers are being pulled into the labor force by rising real wages and the recognition that jobs are becoming easier to find. over a longer period stronger demand should support increased
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investment driving productivity higher. moreover as the economy tightens firms have rising incentives to get more out of every dollar of capital and every hour of work. real-time estimates of potential output are highly uncertain. forecasts of potential growth even more so. we can estimate the growth of the working age population reasonably well. future levels of labor force participation are less certain and least certain of all are forecasts of tfp. if the optimists are right there will eventually be another wave of productivity growth driven by the truly remarkable evolution of technology and higher potential growth and faster increases of living standards and a return to higher interest rates over time. what if the pessimists are right and productativity growth remains low for another deckate or indefinitely? the consequences would include lower potential growth and relatively lower living standards and our long-term fiscal challenges would be that much greater.
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turning to monetary policy. the implications for monetary policy of these supply-side issues have been limited but they begin to matter more as we near full employment. so, for the near term my baseline expectation is that our economy will continue on its path of growth around 2%. to confirm that expectation it will be important to see a significant strengthening in growth in the second quarter after the apparent softness of the last two quarters. to support this growth narrative i also expect the ongoing healing process in labor markets to continue with strong job growth, further reductions in headline unemployment and other measures of slack and increases in wage inflation. as the economy tightens i expect inflation will continue to move over time to the committee's 2% objective. if the incoming data continues to support the expectations i would see it as appropriate to continually gradually raise the fund rate.
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another rate increase may be appropriate fairly soon. several factors suggest that the pace of rate increases should be gradual. including the asymmetry of the risks at zero lower bound, downside risks, and a lower long-run neutral federal funds rate and the apparently elevated sensitivity of financial conditions to monetary policy. uncertainty about the location of supply-side constraints provides another reason for gradualism. there are potential concerns with this gradual approach, however. it's possible that monetary policy could push resource utilization too high and inflation could move temporarily above target. in an era of anchored inflation expectations undershooting of the natural rate of unemployment should result in a temporary increase in the inflation rate. but running the economy above its potential growth rate for an extended period could involve significant risks.
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a long period of very low interest rates could lead to excessive risk taking and over time to unsustainably high asset prices and credit growth. macroprudential and other policies are designed to reduce both the likelihood of such an outcome and the severity of the consequences if it does occur. but it is not certain that these tools would prove adequate in a financial system in which intermediation takes place outside the regulated banking sector. thus developments along these lines could ultimately present a difficult set of trade-offs for monetary policy. to wrap up for now with the support of monetary accommodation our economy has made substantial progress. my view is that a continued gradual return to more normal monetary policy settings will give us the best chance to continue to make up lost ground. thanks very much and i look forward to our discussion.
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>> fabulous. >> that's me. thank you so much, jay. we obviously have a very expert audience and a lot of people waiting to ask you questions, but if i could i'd just like to pose a couple to start. towards the end of your speech you mentioned the idea of -- i'm trying to find the exact words so i don't end up saying something wrong. the apparently elevated sensitivity of financial conditions to monetary policy. that leads me to two questions.
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first is, it's interesting to juxtapose that with an apparent diminished sensitivity of real investment to monetary policy. i mean, that seems to be the big uphill battle central banks have been facing for the last few years. is there -- given particularly your financial markets background, what do you think leads to this divergence between monetary policy seeming to have more effect on asset markets and less effect than in the past on investment? >> okay. so, what i was referring to there and there's so many different ways to try to -- try to relate changes in financial conditions to changes in expectations about monetary policy. but this was a statement based
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on one look which is to look at the differences between expectations -- forward expectations for rates in other advanced economies and the united states and look at changes in that spread and look at the effect that would have on the dollar. and it seems that that effect has been higher than expected. so, by that particular measure, and that would explain some of the quite large move in the dollar since the middle of 2014. you're asking, though, about the tension between that and really low capital investment in the face of very low interest rates. as i mentioned in my speech, you know, we look at it in sort of standard, accelerator model terms and other frameworks as well. and, you know, come pretty much to the view that low capital investment is explained largely by weak demand. businesses don't have to invest because demand is weak. it's no more complicated than that. i would say also, though, based on my, you know, long career in dealing with private sector companies, if you put yourself
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in the seat of someone responsible for management of a company, you know, they see weak demand. they cut costs. they can buy back their stock, and they can make their numbers that way for a period of time. so, investment is low. but it's a way for you to make your numbers without taking a lot of risk. >> right. >> if you think about where that takes you over a period of 10 or 15 years is kind of a hollowed-out economy, so it's not a great trend. we don't see a residual to explain, though, in terms of our basic framework for investment. >> great. so, secondly you raise the issue of the dollar. obviously i'm not going to ask you about any particular level or intervention, but just more broadly. we're being forcibly made aware of various other countries' concerns about the dollar, their reactions, other central banks, to the dollar. in the same spirit as my last
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question, how do you think about the chatter sometimes that the federal reserve can't raise monetary policy as much as they would like -- tighten monetary policy as much as they would like because the dollar effects are so large? >> well, let me begin by echoing your point, of course, we don't have anything to do with managing the level of the dollar. >> this is about transition. >> i'm getting that ritual disclaimer out of the way in case there are treasury people here or watching. so, i think what happened is since the middle of '14 financial conditions tightened significantly. and not through the traditional channel of interest rates, so in effect we had to tighten less is what happened. it's not to say that we can't tighten policy. the point is to tighten financial conditions, not to raise interest rates, right? so, we do what we think is appropriate and i think we had the freedom to do that.
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but we do have to take into consideration, you know, conditions around the world and one of many financial conditions we've got to evaluate is, of course, the level of the dollar. >> great. thank you very much. i'm now going to open it up to our audience for questions. the -- some very simple ground rules. please wait to be recognized. if you're recognized, please identify yourself, please pretend you are asking a question. if you do something that resembles a speech, i will cut you off. in practical terms, we have a traveling mike up here up front, which chris is holding, and people towards the back can feel free to stand at the standing mike. who would like to go first under that horrible threat i just issued? right here. >> so one question i had was -- >> identify yourself. >> sorry. jonathan pingle from black rock. the arguments for caution and facing the problems of
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asymmetric policy response near the zero lower bound sound reasonable as sort of a justification for proceeding gradually. however, trying to understand exactly what that means for the path forward, say, maybe one hike or two hikes this year, maybe three or four next year, or does that mean two next year? it's difficult to see out of the next two, three years how we intercept that relative to, you know, a historical hiking pattern which would have been, say, faster, or does this mean something incredibly slow? for example, just thinking about the dot plot, the median dots for 2017 have four hikes priced in. how do you reconcile that with asymmetry and gradualism? i mean, is that gradual in your view? does that incorporate the inability to respond to downside risks? i mean, how do we reconcile this gradualism with what we see in
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the dots? is the dots gradualism? >> or as i would put it, do the dots matter at all? >> so the dots really represent -- i'm sure you know -- individual participants' estimates of appropriate monetary policy, given and in consideration of a modell forecast. so i would say that anyone's ability to forecast much beyond the next few months is really not so great. just the standard error is around everyone's forecast are quite large. so you -- the way to think about it is not a promise, it's not a statement of an intention. it's statement of what someone would think monetary policy would be -- what would be appropriate given that motile forecast. that's the only way to think about it. if you think of it as doesn't that sound like a lot? no that doesn't sound like a lot if the forecast is realized and if other financial conditions
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are about as expected. we had a conference about this in new york a couple of months ago. the challenges of communicating around the dots are substantial. people do tend to take them more as promises and sort of not see the conditionality. i'm not saying you're doing that, jonathan, but they're not without challenges. >> very nicely put. who would like to go next? please, the gentleman over there. >> thank you. i'm the ambassador of mozambique. i want to thank the peterson institute for providing the opportunity and also for this illuminating presentation. in your presentation, you mentioned i would say by passing the geopolitics, the

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